A nurse is teaching a newly licensed nurse about didanosine therapy.
Which of the following client conditions should the nurse identify as an indication for treatment with didanosine?

Choice A rationale

Amiodarone is known to cause various adverse effects, but ototoxicity leading to hearing impairment is not a commonly reported or significant side effect. The primary concerns with amiodarone involve pulmonary, thyroid, hepatic, and ocular toxicities. Therefore, routine hearing screenings are not a standard intervention in the care plan for clients on amiodarone.

Choice B rationale

An increase in appetite is not a recognized or common adverse effect associated with amiodarone. Amiodarone can cause gastrointestinal side effects such as nausea, vomiting, and anorexia, but an increased appetite is not typically observed. Monitoring for such a symptom would not be a priority in the client's plan of care.

Choice C rationale

Amiodarone is extensively metabolized by the liver and is known to cause hepatotoxicity, ranging from asymptomatic transaminase elevation to severe hepatitis and cirrhosis. Therefore, periodic monitoring of liver enzyme levels (e.g., AST, ALT, alkaline phosphatase) is crucial to detect early signs of liver injury and adjust treatment if necessary. Normal AST levels are typically 10-40 U/L, and ALT levels are 7-56 U/L.

Choice D rationale

While some medications can cause psychiatric disturbances, manic behavior is not a commonly reported or characteristic adverse effect of amiodarone. The central nervous system effects of amiodarone are more likely to include peripheral neuropathy, ataxia, and tremors. Monitoring for manic behavior is not a standard intervention for clients on amiodarone therapy.

Choice A rationale

Constipation is not a commonly associated adverse effect of ciprofloxacin. Fluoroquinolones primarily impact gastrointestinal motility through alterations in gut flora and direct irritation, often leading to diarrhea or abdominal discomfort rather than constipation. The drug's mechanism does not typically promote slowed bowel movements or decreased peristalsis.

Choice B rationale

Weight gain is not a typical adverse effect of ciprofloxacin. Fluoroquinolones do not directly influence metabolic pathways or fluid retention in a manner that would lead to increased body mass. Adverse effects are usually related to gastrointestinal disturbances, neurological effects, or musculoskeletal issues.

Choice C rationale

Phototoxicity is a significant adverse effect of ciprofloxacin, a fluoroquinolone antibiotic. This occurs due to the drug's ability to absorb ultraviolet radiation, leading to a photochemical reaction that damages skin cells. This damage can manifest as severe sunburn, blistering, or rash upon exposure to sunlight.

Choice D rationale

Bradycardia is not a recognized adverse effect of ciprofloxacin. While some antibiotics can rarely affect cardiac conduction, ciprofloxacin's primary cardiovascular concerns relate more to QT prolongation and potential arrhythmias, not typically a decrease in heart rate. Its mechanism does not directly depress sinoatrial node function.